1. Field of the Invention
This invention relates to orthopedic implants used in the internal fixation of bone fractures in living human beings and animals, to a method of fracture fixation which preserves the vascular integrity of the cortex and periosteum of the bone structure, and to an applier means for insertion of implants into a fractured bone. While not so limited, the implants of the invention have particular utility in cerclage (circumferential wiring) and hemicerclage wiring in combination with intramedullary pins for fixation of fracture of long bones. The invention provides improvements in the general principles applicable to repair of fractures, viz., anatomical reconstruction, preservation of vascularity, rigid internal fixation, minimum trauma, and early ambulation.
2. Description of the Prior Art
Circumferential wiring for orthopedic procedures in humans and animals has been practiced for a number of years, particularly in the treatment of fractures of the long bones. It has also been used in combination with intramedullary pinning. However, problems have been encountered, including fracture non-union becuase of impairment of circulation or poor fixation, and resorption of bone under the wire.
When simple cerclage or bone bands are used conventionally for immobilization and stabilization of fractures, the wire or band frequently must be removed within several months after installation in order to avoid ring-like sequestrum. This removal requires additional surgery, and if removal is not affected within the appropriate time a new fracture may appear in the area of the sequestra, thus incurring secondary complications.
U.S. Pat. No. 887,074, issued to DePage, discloses a surgical screw bolt having a wire connected to it, the wire being provided to aid in drawing the bolt through an opening.
Plates, screws, pins and the like for fixation of complex bone fractures, are disclosed in U.S. Pat. Nos. 3,477,429; 3,469,573; 3,463,148; 3,334,624; 3,111,945 and 2,602,445.
The use of such devices generally involve removal thereof from the bone after union by additional surgery, which was often major.
It is therefore evident that a genuine need exists for orthopedic devices and a method for the internal fixation of bone fractures which avoids the above problems and which will permit the use of multiple full cerclage wires or hemicerclage wires either with or without intramedullary pinning.